2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T707,Steatotic liver disease (SLD) and liver fibrosis are major comorbidities in people with HIV (PWH). Guidelines recommend stepwise screening using the Fibrosis-4 (FIB-4) index followed by transient elastography (TE), yet its accuracy and the extent of FIB-4 misclassification in PWH remain uncertain. We evaluated the diagnostic performance of FIB-4 against TE, quantified missed fibrosis, and assessed whether metabolic and HIV-specific factors improve risk prediction. We conducted a multinational study of 4,917 PWH without viral hepatitis coinfection or hazardous alcohol intake undergoing TE screening across seven centers. SLD was defined by controlled attenuation parameter >275 dB/m and classified as metabolic dysfunction-associated SLD (MASLD) or metabolic dysfunction-associated alcohol-related liver disease (MetALD). Significant fibrosis (liver stiffness measurement [LSM] ≥8 kPa) was present in 12.6% of participants, advanced fibrosis (LSM ≥11 kPa) in 6.1%, and SLD in 21.7% (20.6% MASLD, 1.1% MetALD). FIB-4 showed modest accuracy for significant fibrosis (AUROC 0.69, 95% CI 0.67-0.72) and misclassified 36% of fibrosis cases as low risk (FIB-4 <1.3). Performance was poorer in MASLD than in non-MASLD (AUROC 0.60 vs 0.76; p <0.001). Participants with false-negative FIB-4 exhibited a more metabolic phenotype, including higher BMI and steatosis. Incorporating metabolic and HIV-specific factors improved discrimination and reclassification and enabled development of the FIB-HIV score, which outperformed FIB-4 (AUROC 0.78 vs 0.69; p <0.001). In PWH, liver fibrosis is common and frequently missed by FIB-4, particularly in MASLD. TE-centered screening strategies augmented by metabolic and HIV-specific indicators may improve early fibrosis detection and risk stratification.31:T9b6, Background and Aims: Steatotic liver disease (SLD) and liver fibrosis are major comorbidities in people with HIV (PWH). Guidelines recommend stepwise screening using the Fibrosis-4 (FIB-4) index followed by transient elastography (TE), yet its accuracy and the extent of FIB-4 misclassification in PWH remain uncertain. We evaluated the diagnostic performance of FIB-4 against TE, quantified missed fibrosis, and assessed whether metabolic and HIV-specific factors improve risk prediction. Approach and Results: We conducted a multinational study of 4,917 PWH without viral hepatitis coinfection or hazardous alcohol intake undergoing TE screening across seven centers. SLD was defined by controlled attenuation parameter >275 dB/m and classified as metabolic dysfunction-associated SLD (MASLD) or metabolic dysfunction-associated alcohol-related liver disease (MetALD). Significant fibrosis (liver stiffness measurement [LSM] ≥8 kPa) was present in 12.6% of participants, advanced fibrosis (LSM ≥11 kPa) in 6.1%, and SLD in 21.7% (20.6% MASLD, 1.1% MetALD). FIB-4 showed modest accuracy for significant fibrosis (AUROC 0.69, 95% CI 0.67–0.72) and misclassified 36% of fibrosis cases as low risk (FIB-4 <1.3). Performance was poorer in MASLD than in non-MASLD (AUROC 0.60 vs 0.76; p <0.001). Participants with false-negative FIB-4 exhibited a more metabolic phenotype, including higher BMI and steatosis. Incorporating metabolic and HIV-specific factors improved discrimination and reclassification and enabled development of the FIB-HIV score, which outperformed FIB-4 (AUROC 0.78 vs 0.69; p <0.001). Conclusions: In PWH, liver fibrosis is common and frequently missed by FIB-4, particularly in MASLD. TE-centered screening strategies augmented by metabolic and HIV-specific indicators may improve early fibrosis detection and risk stratification. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Steatotic Liver Disease: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Steatotic Liver Disease (condition). Clinician-written summaries and actionable practice insights. 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First-ever pediatric-specific recommendations and guidance on cirrhosis recompensation are now available as part of this framework."}},{"doi":"10.1038/s41575-026-01235-3","pmid":"42567912","title":"The dynamic spectrum of steatotic liver disease: the global perspective","journal_title":"Nature Reviews Gastroenterology & Hepatology","journal_issn":"1759-5045","published_at":"2026-08-07T00:00:00.000Z","url":"https://doi.org/10.1038/s41575-026-01235-3","source_score":13,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-13T13:22:59.753Z","updated_at":"2026-08-13T13:22:59.753Z","tags":[{"paper_doi":"10.1038/s41575-026-01235-3","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01235-3","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01235-3","tag_type":"condition","value":"Alcohol-Related Liver Disease","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01235-3","tag_type":"condition","value":"Liver Fibrosis","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01235-3","tag_type":"condition","value":"Metabolic Dysfunction-Associated Steatohepatitis","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01235-3","tag_type":"condition","value":"Obesity","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01235-3","tag_type":"condition","value":"Steatotic Liver Disease","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01235-3","tag_type":"condition","value":"Type 2 Diabetes","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01235-3","tag_type":"generic","value":"phosphatidylethanol","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01235-3","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01235-3","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01235-3","tag_type":"modality","value":"Non-Invasive Fibrosis Assessment","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01235-3","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01235-3","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01235-3","tag_type":"warning","value":"No specific patient numbers, effect sizes, or trial data are present in the abstract; quantitative tags such as sample size could not be assigned.","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01235-3","tag_type":"warning","value":"The impact_flag 'practice_changing' is assigned based on the review's explicit advocacy for a paradigm shift in SLD classification and management, but this is a narrative review without primary trial data.","value_numeric":null},{"paper_doi":"10.1038/s41575-026-01235-3","tag_type":"warning","value":"The PDF metadata and full text content do not match the abstract — the uploaded PDF appears to be a USDA food security survey module unrelated to the stated paper on steatotic liver disease. Structured output is based solely on the provided abstract, as no supporting full text on SLD was available.","value_numeric":null}],"summaries":{"what_studied":"This review examines the full spectrum of steatotic liver disease (SLD) — including metabolic dysfunction-associated SLD, combined metabolic and alcohol-related liver disease, and alcohol-related liver disease — with a focus on how cardiometabolic risk factors and alcohol interact dynamically over time.","key_result":"Cardiometabolic risk factors (obesity, type 2 diabetes, hypertension, dyslipidaemia) are highly prevalent across all SLD subtypes and interact synergistically with alcohol to accelerate fibrosis progression; static diagnostic thresholds frequently misclassify patients due to fluctuating risks and under-reporting of alcohol intake.","limitations":"Most emerging pharmacotherapies for metabolic dysfunction-associated steatohepatitis exclude patients with concurrent alcohol use, limiting generalizability to real-world SLD populations; the review does not report original trial data or specific outcome numbers.","practice_takeaway":"Clinicians should use objective alcohol biomarkers (e.g., phosphatidylethanol) alongside systematic cardiometabolic risk evaluation and non-invasive fibrosis assessment, rather than relying on static diagnostic categories. Repeated reassessment over time is key, as patients can shift across the SLD spectrum."}},{"doi":"10.14309/ajg.0000000000004114","pmid":"42424626","title":"Dietary Guidelines 2025-2030 For Americans Are Concerning For Liver Health","journal_title":"American Journal of Gastroenterology","journal_issn":"0002-9270","published_at":"2026-07-09T00:00:00.000Z","url":"https://doi.org/10.14309/ajg.0000000000004114","source_score":12,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-18T13:39:57.977Z","updated_at":"2026-07-18T13:39:57.977Z","tags":[{"paper_doi":"10.14309/ajg.0000000000004114","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004114","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004114","tag_type":"condition","value":"Cirrhosis","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004114","tag_type":"condition","value":"Liver Fibrosis","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004114","tag_type":"condition","value":"Steatotic Liver Disease","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004114","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004114","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004114","tag_type":"modality","value":"Dietary Intervention","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004114","tag_type":"sample_size","value":"n=10944","value_numeric":10944},{"paper_doi":"10.14309/ajg.0000000000004114","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004114","tag_type":"study_design","value":"Cross-Sectional Study","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004114","tag_type":"warning","value":"The alcohol 'adherence score' was derived from DGA-2020 thresholds (prior guidelines), not a validated clinical tool—interpretation should be made with caution.","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004114","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the study's direct critique of active federal dietary policy (DGA-2025), but causal conclusions are limited by the cross-sectional design.","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004114","tag_type":"warning","value":"VCTE was used for liver assessment; results may not perfectly align with biopsy-based staging.","value_numeric":null}],"summaries":{"what_studied":"This cross-sectional study of 10,944 U.S. adults (NHANES 2017–2023) examined how individual dietary components—scored via HEI-2020 and energy-adjusted z-scores aligned to DGA-2025 food groups—relate to steatotic liver disease (SLD), fibrosis, and cirrhosis, using vibration-controlled transient elastography (VCTE) as the outcome measure.","key_result":"Higher intake of fruits, vegetables, greens and beans, whole grains, and seafood/plant protein was linked to lower odds of SLD and fibrosis; higher intake of red/processed meats, sodium, total protein, saturated fat, and added sugars was linked to greater prevalence. In stepwise models, greens and beans, seafood/plant protein, saturated fat, and alcohol use were retained as independent predictors. Notably, DGA-2025-emphasized components (total protein, red meat) were associated with greater fibrosis risk, while several protective components were omitted from the updated guidelines.","limitations":"- Cross-sectional design limits causal inference.\n- Dietary assessment relied on a single 24-hour recall, which may not reflect habitual intake.\n- VCTE-based fibrosis staging is a surrogate; histologic confirmation was not available.","practice_takeaway":"Counsel patients at risk for fatty liver disease to prioritize plant-based proteins (legumes, seafood) and limit red/processed meat, saturated fat, and added sugars—patterns not fully reflected in the DGA-2025. The complete omission of alcohol guidance in DGA-2025 is a notable gap, as alcohol adherence was one of the strongest protective factors for liver outcomes in this analysis."}},{"doi":"10.1016/s2468-1253(26)00015-4","pmid":"42385752","title":"The role of primary care in response to the global liver disease syndemic: a Lancet Gastroenterology & Hepatology Commission","journal_title":"The Lancet Gastroenterology & Hepatology","journal_issn":"2468-1253","published_at":"2026-07-01T00:00:00.000Z","url":"https://doi.org/10.1016/s2468-1253(26)00015-4","source_score":8,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-07T13:26:11.958Z","updated_at":"2026-07-07T13:26:11.958Z","tags":[{"paper_doi":"10.1016/s2468-1253(26)00015-4","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00015-4","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00015-4","tag_type":"condition","value":"Alcohol-Related Liver Disease","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00015-4","tag_type":"condition","value":"Chronic Viral Hepatitis","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00015-4","tag_type":"condition","value":"Liver Disease","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00015-4","tag_type":"condition","value":"Metabolic Dysfunction-Associated Steatotic Liver Disease","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00015-4","tag_type":"condition","value":"Steatotic Liver Disease","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00015-4","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00015-4","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00015-4","tag_type":"modality","value":"Digital Health Innovation","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00015-4","tag_type":"modality","value":"Multidisciplinary Care","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00015-4","tag_type":"modality","value":"Primary Care","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00015-4","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00015-4","tag_type":"study_design","value":"Commission Report / Narrative Review","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00015-4","tag_type":"warning","value":"No original clinical data or quantitative outcomes are reported; this is an expert Commission and evidence synthesis, not a primary study. Level of evidence reflects expert consensus only.","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00015-4","tag_type":"warning","value":"The study design label 'Commission Report' does not map to a standard RCT/observational hierarchy; level of evidence set to 7 (expert opinion/narrative review).","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(26)00015-4","tag_type":"warning","value":"The term 'syndemic' is used to describe the co-occurrence and interaction of liver disease with social determinants and other conditions — clinicians unfamiliar with this framing should note it is a conceptual/public health lens, not a clinical diagnosis.","value_numeric":null}],"summaries":{"what_studied":"This Lancet Commission reviewed evidence and developed recommendations on the role of primary care in preventing, detecting, and managing liver disease globally, with a focus on reducing health disparities, integrating care for multimorbidity, and leveraging digital innovation.","key_result":"Primary care is identified as uniquely positioned to deliver population-level liver disease prevention and early detection, yet liver disease has received minimal attention in primary care policy, training, and system design worldwide. The Commission issues recommendations across six central themes: reducing inequalities, defining a minimum primary care service package, embedding liver health in NCD strategies, digital innovation, multidisciplinary collaboration, and a coordinated research agenda.","limitations":"As a Commission report, recommendations are based on expert consensus and evidence review rather than primary trial data; no original quantitative analysis or clinical outcomes data are reported. The breadth of the global scope may limit specificity of recommendations for individual health systems.","practice_takeaway":"Primary care clinicians should proactively screen and manage liver disease—especially steatotic liver disease and chronic viral hepatitis—as part of routine NCD care, with particular attention to marginalised and low-socioeconomic-status populations. Integrated, person-centred pathways that address comorbidities like diabetes and mental illness are essential to reducing liver disease burden."}},{"doi":"10.1007/s12072-026-11112-5","pmid":"42337153","title":"Alcohol consumption and dementia risk in steatotic liver disease: a nationwide cohort study","journal_title":"Hepatology International","journal_issn":"1936-0533","published_at":"2026-06-23T00:00:00.000Z","url":"https://doi.org/10.1007/s12072-026-11112-5","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-25T13:25:18.329Z","updated_at":"2026-06-25T13:25:18.329Z","tags":[{"paper_doi":"10.1007/s12072-026-11112-5","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11112-5","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11112-5","tag_type":"condition","value":"Alcohol-Related Liver Disease","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11112-5","tag_type":"condition","value":"Alzheimer's Disease","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11112-5","tag_type":"condition","value":"Dementia","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11112-5","tag_type":"condition","value":"Metabolic Dysfunction-Associated Steatotic Liver Disease","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11112-5","tag_type":"condition","value":"Steatotic Liver Disease","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11112-5","tag_type":"condition","value":"Vascular Dementia","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11112-5","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11112-5","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11112-5","tag_type":"sample_size","value":"n=3071829","value_numeric":3071829},{"paper_doi":"10.1007/s12072-026-11112-5","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11112-5","tag_type":"study_design","value":"Nationwide Cohort Study","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11112-5","tag_type":"warning","value":"SLD subtype classification used the Fatty Liver Index (FLI) rather than imaging or biopsy, which may introduce misclassification.","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11112-5","tag_type":"warning","value":"The cohort is exclusively Korean (National Health Insurance Service data), limiting generalizability to other ethnic populations.","value_numeric":null},{"paper_doi":"10.1007/s12072-026-11112-5","tag_type":"warning","value":"The 'practice_changing' impact flag was applied cautiously — findings are observational and the authors explicitly call for further validation before clinical guidance changes.","value_numeric":null}],"summaries":{"what_studied":"This nationwide cohort study examined dementia risk (all-cause, Alzheimer's disease, and vascular dementia) across steatotic liver disease (SLD) subtypes — MASLD, MetALD, and ALD — in 3,071,829 Korean adults without baseline dementia, followed from a 2012 health examination over a median of 5.4 years.","key_result":"72,545 all-cause dementia, 56,999 AD, and 8,923 vascular dementia cases occurred. ALD carried the highest dementia risk across all outcomes, followed by MASLD. MetALD showed largely neutral associations, except for a modest increase in vascular dementia risk. Within MASLD, the no-alcohol subgroup had consistently elevated risk for all dementia types; moderate (within-threshold) alcohol intake showed mixed results.","limitations":"- SLD classification relied on a single baseline health exam; longitudinal changes in liver or alcohol status were not tracked.\n- Alcohol intake was self-reported and subject to underreporting bias.\n- Residual confounding from unmeasured factors (e.g., diet, genetics, education) cannot be excluded.","practice_takeaway":"Patients with ALD or MASLD — especially those who abstain from alcohol — should be considered at elevated dementia risk and monitored accordingly. The neutral-to-modest signal in MetALD suggests alcohol's interaction with metabolic liver disease is complex, warranting individualized counseling rather than blanket guidance."}},{"doi":"10.1097/lvt.0000000000000922","pmid":"42233666","title":"Pre-Transplant Cardiac Evaluation in Liver Transplant Recipients","journal_title":"Liver Transplantation","journal_issn":"1527-6465","published_at":"2026-06-03T00:00:00.000Z","url":"https://doi.org/10.1097/lvt.0000000000000922","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-09T13:50:18.654Z","updated_at":"2026-06-09T13:50:18.654Z","tags":[{"paper_doi":"10.1097/lvt.0000000000000922","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1097/lvt.0000000000000922","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1097/lvt.0000000000000922","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1097/lvt.0000000000000922","tag_type":"condition","value":"Cardiovascular Disease","value_numeric":null},{"paper_doi":"10.1097/lvt.0000000000000922","tag_type":"condition","value":"Cirrhosis","value_numeric":null},{"paper_doi":"10.1097/lvt.0000000000000922","tag_type":"condition","value":"Liver Transplantation","value_numeric":null},{"paper_doi":"10.1097/lvt.0000000000000922","tag_type":"condition","value":"Steatotic Liver Disease","value_numeric":null},{"paper_doi":"10.1097/lvt.0000000000000922","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1097/lvt.0000000000000922","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1097/lvt.0000000000000922","tag_type":"modality","value":"Cardiac Screening / Risk Stratification","value_numeric":null},{"paper_doi":"10.1097/lvt.0000000000000922","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1097/lvt.0000000000000922","tag_type":"warning","value":"This is a narrative review published June 2026; no primary outcome data or sample size is reported. The 'practice_changing' impact flag reflects the updated guidance on cardiac screening in the context of rising steatotic liver disease, but specific recommendations are based on review-level evidence only. Study design classification as 'Narrative Review' is inferred from abstract language; the full text was not available to confirm.","value_numeric":null}],"summaries":{"what_studied":"This review examines pre-transplant cardiac evaluation in liver transplant (LT) candidates, including the prevalence of cardiac pathologies, their impact on waitlist and post-LT outcomes, advances in cardiac screening diagnostics, and initial risk-mitigation strategies — particularly in the context of rising steatotic liver disease.","key_result":"Cardiovascular comorbidities are increasingly prevalent in LT candidates due to the shift toward steatotic-predominant liver disease; adverse cardiac events remain a significant driver of post-LT morbidity and mortality, underscoring the need for accurate pre-LT cardiac risk stratification.","limitations":"As a narrative review, it does not provide primary data or meta-analytic pooling; recommendations may reflect expert opinion rather than high-level evidence. No specific patient cohort or quantitative outcomes are reported.","practice_takeaway":"Screen LT candidates systematically for cardiac risk, especially those with steatotic liver disease, using updated diagnostic tools for better risk stratification. Early identification and management of cardiac comorbidities before listing may improve waitlist and post-transplant survival."}},{"doi":"10.1016/j.jhep.2026.04.029","pmid":"42191458","title":"EASL position paper on preclinical models of steatotic liver disease","journal_title":"Journal of Hepatology","journal_issn":"0168-8278","published_at":"2026-05-27T00:00:00.000Z","url":"https://doi.org/10.1016/j.jhep.2026.04.029","source_score":4,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-04T13:23:40.328Z","updated_at":"2026-06-04T13:23:40.328Z","tags":[{"paper_doi":"10.1016/j.jhep.2026.04.029","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.04.029","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.04.029","tag_type":"condition","value":"Alcohol-Associated Liver Disease","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.04.029","tag_type":"condition","value":"Hepatocellular Carcinoma","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.04.029","tag_type":"condition","value":"Liver Cirrhosis","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.04.029","tag_type":"condition","value":"Liver Fibrosis","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.04.029","tag_type":"condition","value":"Metabolic Dysfunction-Associated Steatohepatitis","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.04.029","tag_type":"condition","value":"Metabolic Dysfunction-Associated Steatotic Liver Disease","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.04.029","tag_type":"condition","value":"Steatotic Liver Disease","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.04.029","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.04.029","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.04.029","tag_type":"study_design","value":"Position Paper / Narrative Review","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.04.029","tag_type":"warning","value":"No original patient or animal data are presented; this is a consensus/expert position paper, so level of evidence is advisory rather than empirical.","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.04.029","tag_type":"warning","value":"The DOI year (2026) is consistent with the stated publication date; the paper is newly published as of the current date.","value_numeric":null},{"paper_doi":"10.1016/j.jhep.2026.04.029","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the field-wide standardisation implications for preclinical researchers, not direct clinical practice change.","value_numeric":null}],"summaries":{"what_studied":"This EASL position paper critically reviews and classifies preclinical experimental models (in vivo, in vitro, ex vivo) used to study steatotic liver disease (SLD), including MASLD/MASH, MetALD, and ALD, proposing criteria for appropriate model selection across distinct SLD subtypes.","key_result":"The paper proposes a framework for categorising and standardising SLD preclinical models based on criteria spanning systemic and hepatic metabolism, cardiometabolic comorbidities, histopathology, immunopathology, and molecular features relevant to disease stage and aetiology.","limitations":"As a position paper, recommendations are consensus- and expert opinion-based rather than derived from new empirical data; the breadth of models reviewed may limit the depth of guidance for any single model.","practice_takeaway":"Researchers selecting preclinical SLD models should align model choice with the specific disease subtype (MASLD, MetALD, ALD), disease stage, and translational question using the standardised criteria proposed here. Consistent use of updated nomenclature (e.g., MASLD/MASH replacing NAFLD/NASH) is recommended across experimental SLD research."}},{"doi":"10.1053/j.ajkd.2026.02.641","pmid":"42175979","title":"Obesity in CKD: Core Curriculum 2026","journal_title":"American Journal of Kidney Diseases","journal_issn":"0272-6386","published_at":"2026-05-23T00:00:00.000Z","url":"https://doi.org/10.1053/j.ajkd.2026.02.641","source_score":46,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-26T13:35:04.350Z","updated_at":"2026-05-26T13:35:04.350Z","tags":[{"paper_doi":"10.1053/j.ajkd.2026.02.641","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.02.641","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.02.641","tag_type":"condition","value":"Cardiovascular-Kidney-Metabolic Syndrome","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.02.641","tag_type":"condition","value":"Chronic Kidney Disease","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.02.641","tag_type":"condition","value":"Heart Failure","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.02.641","tag_type":"condition","value":"Obesity","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.02.641","tag_type":"condition","value":"Steatotic Liver Disease","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.02.641","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.02.641","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.02.641","tag_type":"modality","value":"Anti-Obesity Pharmacotherapy","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.02.641","tag_type":"modality","value":"Bariatric Surgery","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.02.641","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.02.641","tag_type":"warning","value":"No original trial data or sample size reported — this is an expert review/curriculum article, not an empirical study; level of evidence and impact flag reflect the review format and clinical scope, not a specific intervention trial.","value_numeric":null},{"paper_doi":"10.1053/j.ajkd.2026.02.641","tag_type":"warning","value":"The 'practice_changing' flag reflects the article's framing of obesity as the leading CKD risk factor and the introduction of new medical/surgical treatment options, but supporting RCT evidence for specific therapies in CKD is not detailed in the abstract.","value_numeric":null}],"summaries":{"what_studied":"This Core Curriculum review examines the diagnosis, controversies, and management of obesity in the context of chronic kidney disease (CKD), including its role in cardiovascular-kidney-metabolic syndrome and implications for dialysis and transplantation.","key_result":"Obesity has surpassed diabetes and hypertension as the most common risk factor for CKD and its progression; it also raises risk for heart failure, sleep apnea, steatotic liver disease, osteoarthritis, multiple cancers, and frailty — and complicates dialysis access and transplant eligibility.","limitations":"As a narrative Core Curriculum review, it does not report original trial data or meta-analytic effect sizes; conclusions rely on cited literature rather than a systematic search with defined inclusion criteria.","practice_takeaway":"Clinicians should treat obesity as a chronic disease requiring long-term, team-based care in CKD patients, using both medical and surgical therapies. Early weight-loss intervention may slow CKD progression and reduce cardiovascular-kidney-metabolic burden simultaneously."}},{"doi":"10.1097/hep.0000000000001773","pmid":"42065895","title":"FIB-4 fails to identify significant liver fibrosis in people with HIV: A large multinational screening study","journal_title":"Hepatology","journal_issn":"0270-9139","published_at":"2026-05-01T00:00:00.000Z","url":"https://doi.org/10.1097/hep.0000000000001773","source_score":22,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-05-08","doi":"10.1097/hep.0000000000001773","days":"7","issn":"0270-9139","rank":"5","field":"Clinical Medicine","score":"22","category":"Gastroenterology & Hepatology","categories":["Gastroenterology & Hepatology"],"_categories":["Gastroenterology & Hepatology"]},"pubmed":{"doi":"10.1097/HEP.0000000000001773","title":"FIB-4 fails to identify significant liver fibrosis in people with HIV: A large multinational screening study.","journal":"Hepatology (Baltimore, Md.)","methods":"","results":"","abstract":"$30","keywords":["FIB-HIV","MASLD","lean phenotype","metabolic risk factors","misclassification","transient elastography"],"pubmed_id":"42065895","conclusions":"","publication_date":"2026-05-01T00:00:00"},"crossref":{"DOI":"10.1097/hep.0000000000001773","URL":"https://doi.org/10.1097/hep.0000000000001773","ISSN":["0270-9139","1527-3350"],"link":[{"URL":"https://journals.lww.com/10.1097/HEP.0000000000001773","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["FIB-4 fails to identify significant liver fibrosis in people with HIV: A large multinational screening study"],"author":[{"given":"Felice","family":"Cinque","sequence":"first","affiliation":[{"name":"Chronic Viral Illness Service, McGill University Health Centre, Montreal, Canada"},{"name":"Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy"}]},{"given":"Sahar","family":"Saeed","sequence":"additional","affiliation":[{"name":"Public Health Sciences, Queen’s University, Kingston, ON, Canada"}]},{"given":"Francesca","family":"Farina","sequence":"additional","affiliation":[{"name":"Chronic Viral Illness Service, McGill University Health Centre, Montreal, Canada"},{"name":"San Raffaele Hospital, Milan, Italy"}]},{"given":"Dana","family":"Kablawi","sequence":"additional","affiliation":[{"name":"Chronic Viral Illness Service, McGill University Health Centre, Montreal, Canada"}]},{"given":"Jihoon","family":"Lim","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Canada"}]},{"given":"Antonio","family":"Cascio","sequence":"additional","affiliation":[{"name":"Department of Health Promotion Sciences and Mother and Child Care “Giuseppe D’Alessandro”, University of Palermo, Palermo, Italy"}]},{"given":"Claudia","family":"Gioè","sequence":"additional","affiliation":[{"name":"Department of Health Promotion Sciences and Mother and Child Care “Giuseppe D’Alessandro”, University of Palermo, Palermo, Italy"}]},{"given":"Emmanuel","family":"Tsochatzis","sequence":"additional","affiliation":[{"name":"UCL Institute for Liver and Digestive Health, Royal Free Hospital and UCL, London, UK"}]},{"given":"Rosa","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy"},{"name":"SC Medicina Indirizzo Metabolico, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy"}]},{"given":"Ahmed","family":"Cordie","sequence":"additional","affiliation":[{"name":"Endemic Medicine Department, Cairo University Hospitals, Cairo, Egypt"}]},{"given":"Rahma","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Endemic Medicine Department, Cairo University Hospitals, Cairo, Egypt"}]},{"given":"Ahmed M.","family":"Kamel","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt"}]},{"given":"Gamal","family":"Esmat","sequence":"additional","affiliation":[{"name":"Endemic Medicine Department, Cairo University Hospitals, Cairo, Egypt"},{"name":"Research Center, Badr University in Cairo, Badr City, Egypt"}]},{"given":"Alessandra","family":"Bandera","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy"},{"name":"Infectious Diseases Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy"}]},{"given":"Jovana","family":"Milic","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy"}]},{"given":"Dominik","family":"Benke","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Venusberg Campus 1, University Hospital Bonn, Bonn, Germany"}]},{"given":"Fauzi","family":"Elamouri","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Venusberg Campus 1, University Hospital Bonn, Bonn, Germany"}]},{"given":"Jürgen K.","family":"Rockstroh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Venusberg Campus 1, University Hospital Bonn, Bonn, Germany"}]},{"given":"Giovanni","family":"Guaraldi","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy"}]},{"given":"Giada","family":"Sebastiani","sequence":"additional","affiliation":[{"name":"Chronic Viral Illness Service, McGill University Health Centre, Montreal, Canada"},{"name":"Center for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Canada"},{"name":"Division of Gastroenterology and Hepatology, Royal Victoria Hospital, McGill University Health Centre, Montreal, Canada"}]}],"issued":{"date-parts":[[2026,5,1]]},"member":"276","prefix":"10.1097","source":"Crossref","volume":null,"created":{"date-time":"2026-05-01T16:00:14Z","timestamp":1777651214000,"date-parts":[[2026,5,1]]},"indexed":{"date-time":"2026-05-07T10:15:07Z","timestamp":1778148907187,"date-parts":[[2026,5,7]]},"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://journals.lww.com/10.1097/HEP.0000000000001773"}},"subtitle":[],"assertion":[{"name":"received","group":{"name":"publication_history","label":"Publication History"},"label":"Received","value":"2026-02-04"},{"name":"accepted","group":{"name":"publication_history","label":"Publication History"},"label":"Accepted","value":"2026-04-04"}],"deposited":{"date-time":"2026-05-07T10:00:49Z","timestamp":1778148049000,"date-parts":[[2026,5,7]]},"issn-type":[{"type":"print","value":"0270-9139"},{"type":"electronic","value":"1527-3350"}],"published":{"date-parts":[[2026,5,1]]},"publisher":"Ovid Technologies (Wolters Kluwer Health)","reference":null,"short-title":[],"update-policy":"https://doi.org/10.1097/lww.0000000000001000","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"original-title":[],"container-title":["Hepatology"],"reference-count":0,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2026,5,1]]},"references-count":0,"short-container-title":[],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1097/hep.0000000000001773","is_oa":false,"title":"FIB-4 fails to identify significant liver fibrosis in people with HIV: A large multinational screening study","updated":"2026-05-05T11:59:32+00:00","published_date":"2026-05-01","best_oa_location":null}},"created_at":"2026-05-10T13:20:41.123Z","updated_at":"2026-05-14T15:13:26.918Z","tags":[{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"condition","value":"HIV Infection","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"condition","value":"Liver Fibrosis","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"condition","value":"Metabolic Dysfunction-Associated Steatotic Liver Disease","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"condition","value":"Steatotic Liver Disease","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"modality","value":"Fibrosis Biomarker Index","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"modality","value":"Transient Elastography","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"sample_size","value":"n=4917","value_numeric":4917},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"study_design","value":"Cross-Sectional Study","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"warning","value":"Age distribution and sex breakdown of the cohort are not specified in the abstract; age_group and sex tags reflect reasonable assumptions for an HIV clinic population.","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"warning","value":"The FIB-HIV score is newly derived in this study; external validation data are not reported in the abstract.","value_numeric":null},{"paper_doi":"10.1097/hep.0000000000001773","tag_type":"warning","value":"The full text retrieved appears to contain an unrelated document (a 2020 GI Society joint statement on racism), not the actual study body. Summary and tags are based solely on the abstract, which provides sufficient detail for most fields but precludes extraction of subgroup data, adjustment variables, or methodological specifics from the full text.","value_numeric":null}],"summaries":{"what_studied":"Diagnostic accuracy of FIB-4 index vs. transient elastography (TE) for significant liver fibrosis in 4,917 people with HIV (PWH) without viral hepatitis coinfection or hazardous alcohol use, across seven multinational centers; also assessed whether metabolic and HIV-specific factors could improve risk prediction.","key_result":"FIB-4 showed only modest accuracy for significant fibrosis (AUROC 0.69) and missed 36% of cases (false-negative rate at FIB-4 <1.3 cutoff); performance was worse in MASLD vs. non-MASLD (AUROC 0.60 vs. 0.76, p<0.001). A new FIB-HIV score incorporating metabolic and HIV-specific factors outperformed FIB-4 (AUROC 0.78 vs. 0.69, p<0.001). Significant fibrosis (LSM ≥8 kPa) was present in 12.6% and SLD in 21.7% of participants.","limitations":"- Observational, cross-sectional design limits causal inference and assessment of clinical outcomes.\n- TE used as reference standard rather than liver biopsy, which may affect fibrosis classification accuracy.\n- The FIB-HIV score was derived and not externally validated in an independent cohort.","practice_takeaway":"FIB-4 alone should not be relied upon to rule out significant fibrosis in PWH, especially those with metabolic risk factors or MASLD — TE-based screening is more appropriate in this population. Clinicians should consider metabolic and HIV-specific factors when stratifying fibrosis risk in PWH."}},{"doi":"10.1016/j.cgh.2026.03.004","pmid":"41935595","title":"Episodic Heavy Drinking and Implications for Steatotic Liver Disease Nomenclature: A National Cross-Sectional Study","journal_title":"Clinical Gastroenterology and Hepatology","journal_issn":"1542-3565","published_at":"2026-04-03T00:00:00.000Z","url":"https://doi.org/10.1016/j.cgh.2026.03.004","source_score":286,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-07T22:49:46.457Z","updated_at":"2026-05-07T22:49:46.457Z","tags":[{"paper_doi":"10.1016/j.cgh.2026.03.004","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.03.004","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.03.004","tag_type":"condition","value":"Alcohol-Associated Liver Disease","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.03.004","tag_type":"condition","value":"Liver Fibrosis","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.03.004","tag_type":"condition","value":"Metabolic Dysfunction-Associated Steatotic Liver Disease","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.03.004","tag_type":"condition","value":"Steatotic Liver Disease","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.03.004","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.03.004","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.03.004","tag_type":"modality","value":"Vibration-Controlled Transient Elastography","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.03.004","tag_type":"sample_size","value":"n=8006","value_numeric":8006},{"paper_doi":"10.1016/j.cgh.2026.03.004","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.03.004","tag_type":"study_design","value":"Cross-Sectional Study","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.03.004","tag_type":"warning","value":"Episodic heavy drinking thresholds differ by sex (≥4 drinks for women, ≥5 for men per day, at least monthly); this definition may not align with all clinical or guideline definitions of binge drinking.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.03.004","tag_type":"warning","value":"The impact_flag 'practice_changing' reflects a nomenclature reclassification implication, but the study is cross-sectional — causal claims are not supported. Clinicians should interpret the reclassification proposal as hypothesis-generating.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.03.004","tag_type":"warning","value":"The paper is dated April 2026 but the DOI suggests volume 2026 — verify final publication status before citing.","value_numeric":null}],"summaries":{"what_studied":"This cross-sectional study used 2017–2023 NHANES data (adults with vibration-controlled transient elastography) to assess how often episodic heavy drinking occurs across SLD subcategories (MASLD, MetALD, ALD) and whether it is independently associated with significant (≥8 kPa) or advanced (≥12 kPa) liver fibrosis.","key_result":"Among 3,969 MASLD patients, 15.9% had episodic heavy drinking; this was associated with nearly 3-fold higher odds of advanced fibrosis (aOR 2.76; 95% CI 1.58–4.80) and higher prevalence of significant fibrosis (23.6% vs. 15.6% without episodic heavy drinking). Reclassifying these patients would more than double MetALD prevalence (5.3% → 12.9%).","limitations":"Cross-sectional design prevents causal inference. Alcohol use is self-reported, subject to under-reporting bias. Liver stiffness by transient elastography may be confounded by inflammation or obesity.","practice_takeaway":"Ask MASLD patients specifically about episodic (binge) drinking — not just average intake — as it carries significantly higher fibrosis risk. Current SLD nomenclature based on average consumption alone may misclassify a meaningful share of higher-risk patients."}}],"initialOffset":10,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Steatotic Liver Disease"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Steatotic Liver Disease"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Steatotic Liver Disease"}}}]]

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